Job Description

STATE OF COLORADO RESIDENCY REQUIRED AT TIME OF APPLICATION

NOTE: This announcement may be used to fill multiple openings.

The  Department of Health Care Policy & Financing (HCPF) oversees and operates  Health First Colorado (Colorado's Medicaid Program),  Child Health Plan Plus (CHP+), and other state public health programs for qualified Coloradans. Our mission is to improve health care equity, access and outcomes for the people we serve while saving Coloradans money on health care and driving value for Colorado. 

We are committed to increasing the diversity of our staff and providing culturally responsive programs and services. Therefore, we encourage responses from people of diverse backgrounds and abilities.  

As part of the State of Colorado, HCPF offers a  competitive benefits package:

• PERA retirement benefits including PERA Defined Benefit Plan, PERA Defined Contribution Plan, plus 401K and 457 plans

• Medical Dental , and  Vision insurance coverage

• Flexible Spending Accounts (FSAs)

• Family Medical Leave Act (FMLA)job protection and State of Colorado Paid Family Medical Leave (PFML)

• Accrued Sick Leave for State of Colorado Temporary Employees

• Flexplace and Flextime work arrangements

• Variety of discounts on services and products available through the State of Colorado's Work-Life  Employment Discount Program

• Free  RTD EcoPass to all eligible State Employees

• Credit Union of Colorado  Membership Eligibility

• Some positions may qualify for the Public Service Loan Forgiveness Program. For more

information, go to  .

The Eligibility Contracts and Site Relations Section is responsible for oversight of eligibility sites and vendors' contracts regarding client's eligibility for Medical Assistance (MA) Programs. This includes interpreting state and federal regulations concerning eligibility across several categorical assistance programs, ensuring compliance with state and federal regulations and laws, and ensuring timely enrollment of clients into MA Programs through the application process and Colorado Benefits Management System (CBMS). This is accomplished through research, analysis, written and verbal communication with vendors, Medicaid clients, county and eligibility staff, and formal training for field agents (i.e., county departments of social/human services, vendors, medical assistance sites.) This section works with others to implement system and rule changes concerning medical eligibility policy and practices and is responsible for ensuring contracted eligibility sites effectively implement the system, policy and process changes required for accurate and timely eligibility determinations.

 
The C&SR Section monitors contracted eligibility sites and vendor operations to ensure contractual compliance, program integrity, and quality service to our clients. The section also monitors and manages agreements with community partners, the State Health Exchange and other State Departments for the purposes of eligibility determinations, to include agreements for the maintenance and administration of the CBMS. The section is responsible for relationship building and effective and collaborative site relations between the Department, county departments of human/social services, other eligibility sites, stakeholders and additional partners, which are accomplished through meeting attendance, communications and site visits. This section is responsible for the drafting and renegotiation of, as applicable, eligibility sites and vendors' contractual documents regarding the client's eligibility process.

We are onboarding new employees using a hybrid approach. The Department supports flexible work arrangements. Depending on the business need and description of the position, we have options that range from hybrid, to full-time in the office. Specific discussions about the schedule will be discussed during the offer stage. 

This position operates independently to develop and implement procedures for oversight and monitoring of the Hospital Presumptive Eligibility (PE) Program and Agreements in compliance with Department policies and established processes. The position is required to maintain an extensive level of knowledge as the subject matter expert for the PE Program for the purpose of providing effective oversight to the hospitals participating in the PE Program. Participating hospitals assist families with applications for Medical Assistance programs administered by the State.

 
Responsibilities in this position include:

• Manage the Hospital PE Program and related processes and ensure effective collaboration of PE with other eligibility sites. 
• Designated contact between the hospitals participating in the PE Program and the Department, and works to ensure that each site performs in accordance with established processes.
• Monitor performance, conduct case reviews, perform recertification of sites, conduct research for timely and accurate resolutions and communicate relevant information.
• Work with community partners and other stakeholders to identify and recommend updates to the Hospital PE Program processes to ensure that Department goals are met.
• Create and modify the Hospital PE Program trainings as appropriate, maintain certification and performance records.
• Collect and perform analysis of monthly reports to maintain accountability for all sites. Work with other eligibility staff to provide accurate and informative updates regarding Medical Assistance program rule changes.
• Primary contact and communication resource for all Hospital PE Program Sites.
• Foster and maintain positive, collaborative, transparent Eligibility Site relations between hospitals, county departments of human/social services, other eligibility sites, additional partners and stakeholders, and the Department.
• Assist in the procurement process, contract/agreement development, annual renegotiation, request for proposals, development, and document clearance for eligibility site contracts and agreements within the Section that are specific to hospitals enrolling and performing as a designated Hospital PE Site.

Residency Requirement: 

This posting is only open to residents of the State of Colorado at the time of submitting your application. 

Class Code & Classification Description: (New)

H1B3XX

MINIMUM QUALIFICATIONS:

Experience Only:

Six (6) years of relevant experience in an occupation related to the work assigned to this position

OR

Education and Experience:

A combination of related education and/or relevant experience in an occupation related to the work assigned equal to six (6) years

Preferred Qualifications

• Experience working with Medicaid and CHP+ policies and programs

• Experience with monitoring and oversight of public assistance programs, including the ability to conduct audits or reviews ensuring program compliance

• Experience communicating with external stakeholders

• Effective time management and organization; possess the ability to manage multiple tasks at the same time, prioritize tasks based on urgency and deadlines, and utilize available tools or materials to maintain an organized work environment. 

DEFINITION OF PROFESSIONAL EXPERIENCE: Work that involves exercising discretion, analytical skill, judgment, personal accountability, and responsibility for creating, developing, integrating, applying, and sharing an organized body of knowledge that characteristically is uniquely acquired through an intense education or training regimen at a recognized college or university; equivalent to the curriculum requirements for a bachelor's or higher degree with major study in or pertinent to the specialized field; and continuously studied to explore, extend, and use additional discoveries, interpretations, and application and to improve data, materials, equipment, applications and methods. 

CONDITIONS OF EMPLOYMENT:

• All positions at HCPF are security sensitive positions and require that the individuals undergo a criminal record background check as a condition of employment.

• Employees who have been disciplinary terminated, resigned in lieu of disciplinary termination, or negotiated their termination from the State of Colorado must disclose this information on the application.   

Appeal Rights: (Updated)

An applicant who has been removed from an employment list or removed from consideration during the selection process may request a review by the State Personnel Director.

As an applicant directly affected by the results of the selection or comparative analysis process, you may file a written appeal with the State Personnel Director.

Review of the completed, signed and submitted appeal will be timely on the basis of written material submitted by you, using the official appeal form signed by you or your representative. This form must be completed and delivered to the State Personnel Board by email at  [email protected] within ten (10) calendar days from your receipt of notice or acknowledgement of the Department’s action.

For further information on the Board Rules, you can refer to 4 Colorado Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, at spb.colorado.gov/board-rules .

How to Apply (PLEASE READ CAREFULLY)

Please note that ONLY your State of Colorado job application will be reviewed during the initial screening; if you submit a resume and cover letter, they will be reviewed in later stages of the selection process. Therefore, it is paramount that you clearly describe all your relevant experience on the application itself. Applications left blank or marked "SEE RESUME" will not be considered.

Your application will be reviewed against the minimum qualifications for the position. If your application demonstrates that you meet the minimum qualifications, you will be invited to the comparative analysis process, which is described below.

Comparative Analysis Process

The comparative analysis process will consist primarily of a review of applications against the minimum and preferred qualifications of this position. Applications will be reviewed in comparison to all others in the applicant pool in order to identify a top group of candidates who may be invited for a final interview. Depending on the size of the applicant pool, additional selection processes may be utilized to identify a top group of candidates. Applicants will be notified of their status via email.

Failure to submit properly completed documents by the closing date will result in your application being rejected.

ADAAA Accommodations : The State of Colorado believes that equity, diversity, and inclusion drive our success, and we encourage candidates from all identities, backgrounds, and abilities to apply. The State of Colorado is an equal opportunity employer committed to building inclusive, innovative work environments with employees who reflect our communities and enthusiastically serve them. Therefore, in all aspects of the employment process, we provide employment opportunities to all qualified applicants without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity or expression, pregnancy, medical condition related to pregnancy, creed, ancestry, national origin, marital status, genetic information, or military status (with preference given to military veterans), or any other protected status in accordance with applicable law.

The Department of Health Care Policy & Financing is committed to the full inclusion of all qualified individuals. As part of this commitment, our agency will assist individuals who have a disability with any reasonable accommodation requests related to employment, including completing the application process, interviewing, completing any pre-employment testing, participating in the employee selection process, and/or to perform essential job functions where the requested accommodation does not impose an undue hardship. If you have a disability and require reasonable accommodation to ensure you have a positive experience applying or interviewing for this position, please direct your inquiries to our ADAAA Coordinator, Virginia Miller, at  [email protected] .

The Department of Health Care Policy & Financing  does not  offer sponsored visas for employment purposes.

Job Tags

Full time, Contract work, Temporary work, Flexible hours,

Similar Jobs